Reducing Salt Intake for Prevention of Cardiovascular Disease—Times Are Changing

  • Katarzyna Stolarz-Skrzypek
    First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; and Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
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  • Jan A. Staessen
    Address correspondence to Jan A. Staessen, MD, PhD, Studies Coordinating Centre, Laboratory of Hypertension, Campus Sint Rafaël, University of Leuven, Kapucijnenvoer 35, Block D, Box 7001, B-3000 Leuven, Belgium.
    First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; and Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
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      The evidence relating blood pressure to salt intake in humans originates from population studies and randomized clinical trials of interventions on dietary salt intake. Estimates from meta-analyses of trials in normotensive subjects generally are similar to estimates derived from prospective population studies (+1.7 mm Hg increase in systolic blood pressure per 100-mmol increment in 24-hour urinary sodium). This estimate, however, does not translate into an increased risk of incident hypertension in subjects consuming a high salt diet. Prospective studies relating health outcomes to 24-hour urinary sodium excretion produced inconsistent results. Taken together, available evidence does not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level, although the blood pressure-lowering effect of dietary sodium restriction might be of value in hypertensive patients.

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